Charetta L Clark

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

007325154 Issued in LA

Practice address

7125 Suntan St
Shreveport, LA 71108-4927

Phone

(318) 465-6614

NPI assigned

Mar 11, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• C & B Transport 9 LLC

  • Non-emergency Medical Transport (VAN)
  • Shreveport, LA
  • NPI 1033867718
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1811645559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7125 SUNTAN ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711084927",
            "telephone_number": "318-205-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 SUNTAN ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711084927",
            "telephone_number": "318-465-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHARETTA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "LA",
            "license": "007325154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joni Claridy
• Kim Clark-Green
• Allison Simone Clark
• Betty Clark
• Brittni Clark, FNP-C
• David Kyle Clark, DDS
• Earline Mays Clark, BSW
• Eric Vinceson Clark Jr., MHS
• Eric Vinceson Clark Sr.
• Erica Clark

• Non-emergency Medical Transport (VAN) in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Non-emergency Medical Transport (VAN) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.